Ethan T Phan, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

A170167 Issued in CA

Practice address

3000 Q St FL 3
Sacramento, CA 95816-7058

Phone

(916) 733-3400

Fax

(916) 733-5940

NPI assigned

Mar 22, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Louisiana State University School of Medicine in New Orleans, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy General Hospital Hospital, Sacramento, CA, CCN 050017
• Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150
• Woodland Memorial Hospital Hospital, Woodland, CA, CCN 050127
• Methodist Hospital of Sacramento Hospital, Sacramento, CA, CCN 050590
• Oroville Hospital Hospital, Oroville, CA, CCN 050030

Merit-based Incentive Payment System (MIPS)

Final score

99.64 of 100Reported as apm

Quality

86.27

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1841373800
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Dignity Health

  • General Acute Care Hospital
  • Folsom, CA
  • NPI 1356389878
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1487694857
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Carmichael, CA
  • NPI 1972541498
  NPD (past)
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Grass Valley, CA
  • NPI 1043456106
  NPD (past)
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Rancho Cordova, CA
  • NPI 1568489268
  NPD (past)
• Sierra Nevada Memorial-Miners Hospital

  • General Acute Care Hospital
  • Grass Valley, CA
  • NPI 1659361392
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Community Care

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1467560599
  Care Compare affiliation
• Dignity Community Care

  • General Acute Care Hospital
  • Woodland, CA
  • NPI 1922116037
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1487694857
  Care Compare affiliation
• Oroville Hospital

  • General Acute Care Hospital
  • Oroville, CA
  • NPI 1871606269
  Care Compare affiliation
• Sierra Nevada Memorial-Miners Hospital

  • General Acute Care Hospital
  • Grass Valley, CA
  • NPI 1659361392
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1083076947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 Q ST FL 3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958167058",
            "telephone_number": "916-733-3400",
            "fax_number": "916-733-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "ETHAN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A170167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2025 Morse Ave",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958252115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Billy Tri Phan, COUNSELOR
• Chau My Phan, DENTIST
• Chinh Phan, D.O.
• Christina Phan
• Danielle Phan
• Hannah Phan, MD
• Hau Duc Phan
• Ho Phan, MD
• Hoa Phan, PHARMD
• Hoat Phan

• Hospitalist Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Hospitalist Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.